Cancer survivors typically adapt well to life following remission; however, some patients still experience lingering negative moods that may develop into depression. There are multiple factors that can contribute to depressive symptoms from somatic symptoms, to emotion and social concerns. When analyzing these contributing factors, an underlying theory of a connection between the symptoms of depression and inflammation was revealed. Although this was not shown to be a causal association, it set forward some theories on the pathogenesis of depression in cancer survivors who may have persistent inflammation following treatment. As cancer patients are a growing group due to improvements in treatment and an aging general population, early identification of high-risk survivors and research into new treatment methods is essential. Depression in survivors can lead to an inability to follow through on medical care, decreased quality of life and poorer patient health outcomes. Currently, depressive symptoms are treated primarily on an individual basis, determining if there is a common underlying biological mechanism that could help scientists develop new guidelines for the treatment of survivors.
Research studies demonstrated interdependence between conditions such as chronic pain, fatigue, sleep disturbance, cognitive impairment and depression. Current published literature on each of these conditions was explored and while each of these conditions have demonstrated connections to inflammatory pathways and specific cytokines, there does not appear to be one common underlying mechanism. Preliminary research has presented some options for future treatments that can mitigate the severity of the inflammation caused during traditional cancer therapies. These preventative measures address certain cytokine pathways that have been associated with negative side effects. As emotional and social concerns can add to a survivor’s stress causing stimulation of inflammatory pathways, evidence-based methods for reducing stress have been discussed and include exercise, psychosocial and occupational therapy interventions as well as legislative advocacy for better insurance coverage.
There are some limitations in the current literature on the topic as much of the survivor research centers on patients who were diagnosed with breast cancer. There are several diverse subgroups of cancer survivors including childhood, adolescent and young adult, and adult cancer survivors, and comprehensive research should be conducted across these cohorts to ascertain which groups are at a higher risk for certain symptoms and stresses. Furthermore, research into novel treatment options has focused mainly on pharmacological solutions to the negative impacts of chemotherapy. While several studies have theorized about possible, persistent biological mechanisms underlying radiotherapy, few drugs have been suggested or developed to combat the late effects of inflammation including fibrosis. Many of the suggested treatments can be given as a co-treatment alongside of chemotherapy, radiotherapy or surgery; in the future, research should be conducted on the effects of reducing inflammatory levels in patients already in remission.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/41275 |
| Date | 09 July 2020 |
| Creators | Jenkins, Kendall Marie |
| Contributors | Levy, Simon, Davies, Theresa A. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
| Rights | Attribution 4.0 International, http://creativecommons.org/licenses/by/4.0/ |
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